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When Doctor Doesn’t Know Best

January 15, 2018

A lot of people go through life thinking that their doctor knows best. After all, doctors go to medical school for many years. They learn a lot of stuff that we know nothing about. But that doesn’t mean that doctors are free from bias. They can be misinformed. They can be paid by weight-loss companies peddling medications and dangerous surgeries. And they can be just as swayed by societal “ideals” as any of us.

Meet Kim. She’s fat. She has bad knees. She doesn’t have bad knees because she’s fat; she was born with kneecaps that sit crooked. She’s had surgery to try to correct this, but her kneecaps don’t want to cooperate. She is, as she says, “put together wrong.”

This is Kim!

Kim knows about doctors whose weight bias has kept them from treating her for her conditions. She’s been advised to lose weight to cure everything from psoriasis to bronchitis. Really! Thankfully, she’s learned to be her own advocate at the doctor’s office. She’s taken the things she’s learned from Big Fit Deal and used them to stand up for herself, to demand treatment for her illnesses and injuries, not the size of her body.

Last year, her knees really started bothering her. Her right knee was swollen, and the pain was so intense that she went to an orthopedic on-call service. The clinic referred her to a doctor who would become her new orthopedist. Although the doctor was pretty sure an MRI wouldn’t show anything, it did: Kim had a torn meniscus. In March of last year, she had surgery to repair it. The surgery went well, and her recovery was rapid.

Last summer, her left knee swelled and became painful. She knew it was her meniscus. The pain was so intense, she had to use crutches. After going through a round of insurance-mandated cortisone injections, which didn’t alleviate her pain, Kim had another MRI, and then another surgery, to—you guessed it—repair the torn meniscus in her left knee. But her recovery has not gone well. She can’t walk like she wants to. She can’t go up and down stairs without pain. The swelling in her knee often goes all the way up her thigh.

This is Kim at the ocean!

Kim’s orthopedist is determined to get to the bottom of the pain. He’s assigned her knee-strengthening exercises, and sent her to physical therapy. And then, late last year, he suggested one other possible solution: weight loss.

Kim said, “He knows that my feelings regarding weight loss include the fact that I know it’s not permanent, and I have other health issues like thyroid disease that make it hard to even lose one pound, let alone the amount I have to lose to make my health professionals happy, and society more comfortable with my body.”

When her doctor suggested that losing weight might help her knee pain, she asked him if he knew of any weight loss that was proven to be permanent, and if he could provide her with proof that, if she were to lose weight, it would guarantee a cure for her knee.

This is one of my favorite pictures of me and Kim!

The doctor laughed, and then told Kim about a new diet that people in his office were having success with. Kim nodded noncommittally. “Then,” Kim said, “he went there.” The orthopedist suggested lap band surgery.

It was Kim’s turn to laugh. “I told him that unless a doctor told me that I was going to die next week if I didn’t have some kind of weight loss surgery, I would never, ever abuse my body by doing something like that.”

Kim went on to explain her history of knee issues, dating back to high school, when she was much thinner, and very active in varsity sports. The doctor raised his hand in surrender, and said, “Okay, okay, okay. I just thought I would try.”

Kim continues to go to physical therapy. She is still limited by the pain in her knee, exacerbated by arthritis. “I know that it could be so much worse,” she said. “But I also know it could be so much better.”

And here’s a picture of Kim and me at the ocean (one of our favorite places)!

I’m so glad that Kim had the strength to push back on her doctor when he suggested weight loss and weight-loss surgery. Many people assume that their doctor knows best, and only recommends things that are in the best interest for their health. Even when faced with evidence that diets only work short term, and that weight-loss surgery often comes with a host of horrible side effects (at best), doctors still try to bring their fat patients down that well-trodden path.

Kim refused to follow him down that path, and instead took him down the one she’s forging for herself. She is trying to open his eyes and mind to the possibilities that what we are taught about fat bodies—including in medical school—isn’t accurate, safe, or good for the physical, emotional, and mental health of the people who live in those bodies.

Kim puts it best: “We need to continue to educate those who care for our health, and those who would cast aspersions on us because of the space we take up, or the image they have of what our bodies should look like.”